Up until now, Medicare has been fairly structured in how telehealth services are reimbursed. Medicare would pay for telehealth services only if certain, very narrow criteria were met. These rules covered the patient, the patient’s location, the provider, the types of services rendered, the telehealth equipment used and the way the services are coded. Those rules can now be relaxed under recent federal legislation.
On March 6, 2020, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 into law. That law relaxes the current Medicare criteria, in order to expand the use of telehealth as a resource against COVID-19. Pursuant to this law, the Secretary of HHS has the authority to waive the “site” requirements for telehealth services provided to Medicare beneficiaries who are located in an identified “Emergency Area” during an “Emergency Period.” Since the whole country is currently is experiencing a public health emergency, as declared by both the President and the Secretary of HHS, the Emergency Period and Emergency Area requirements are met on a nation-wide basis.
During an Emergency Period, telehealth services may also be provided via telephone, as long as the telephone allows for audio/visual interaction between the beneficiary and the provider. Previously, telephones, even smart phones, did not satisfy the requirements for Medicare reimbursement.
Although these changes are still somewhat limited, and do not relieve providers from complying with applicable state telehealth laws, they do represent a significant relaxation of the strict Medicare criteria. The hope is that the relaxed requirements will result in successful diagnosis, treatment and containment of the coronavirus in the short-term, as well as long-term, post-emergency acceptance of telehealth for the Medicare community.